Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oregon for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oregon only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oregon (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Peacehealth (NPI 1902892391)

Key Findings

Field	Value
Entity Type	Organization
Organization	Peacehealth
Address	1515 Village Dr
City	Cottage Grove
State	OR
ZIP	97424
Taxonomy	Critical Access Hospital
NPI Enumerated	September 21, 2005

Payer Source	Total Paid
Medicaid	$17.2M
Medicare	$0

PEACEHEALTH in COTTAGE GROVE shows an effectively single‑payer footprint: Medicare billing is recorded as none (no Medicare billing on file) while total Medicaid revenue is $17.2M, so all reported lifetime revenue in our dataset comes from Medicaid. This lack of Medicare activity means the provider’s reimbursement mix is heavily concentrated in Medicaid.

Revenue concentration within Medicaid is high: the precomputed top three Medicaid codes (G0463, 99214, 99283) account for 59.4% of the provider’s total Medicaid revenue. Individually those codes are G0463 ($3.9M, 23.3%), 99214 ($3.2M, 19.2%), and 99283 ($2.8M, 16.9%), indicating a small set of services drives the majority of income.

The code mix points to a hybrid outpatient clinic + emergency department operating model consistent with a Critical Access Hospital. G0463 (hospital outpatient clinic visit) is the single largest revenue line at $3.9M (23.3%), and high-volume office E/M 99214 ($3.2M, 19.2%) plus ED E/M codes 99283/99284/99285 together indicate substantial ambulatory and ED throughput rather than a procedure-heavy specialty operation.

Competitive standing varies by code: 99214 ranks #36 of 1503 providers in-state (98th percentile) and is labeled notably above typical state volume, which suggests PEACEHEALTH is a major statewide provider of higher‑complexity established outpatient visits. By contrast G0463, while $3.9M and 23.3% of Medicaid revenue, is described as typical, unremarkable volume in-state (ranks #5 of 44, 91th percentile), so clinic visits appear large but not an extreme outlier among similar hospitals.

Several ancillary outpatient service lines contribute smaller but diverse revenue streams, indicating a broad ambulatory platform. Examples include phlebotomy 36415 (15.4K claims, $384.5K, 2.3%), comprehensive metabolic panel 80053 (9.4K claims, $216K, 1.3%), influenza vaccine 90686 (3.2K claims, $48.1K, 0.3%), and diabetes self‑management G0108 (1.2K claims, $119.7K, 0.7%, ranks #3 of 21 in-state), showing capacity for diagnostics, immunizations, and chronic disease support.

PEACEHEALTH’s Critical Access Hospital taxonomy and long tenure (NPI enumerated 2005-09-21, ~21 years ago) align with a stable, rural acute care provider model that relies on outpatient and ED volume. That longevity combined with the code mix suggests an established local presence focused on primary/urgent care and basic inpatient/ED access rather than high‑volume specialty procedures.

The provider’s heavy reliance on Medicaid ($17.2M and no Medicare revenue on file) and the concentration of 59.4% of Medicaid revenue in three codes creates exposure to shifts in Medicaid policy, enrollment, or coding patterns for ambulatory and ED E/M visits. From a payer or network planning perspective, changes to reimbursement for G0463, 99214, or 99283 would disproportionately affect this provider’s revenue base and should be monitored closely.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

85 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	62,080	$60	$3.9M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	39,440	$80	$3.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	14,620	$190	$2.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	7,730	$340	$2.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	1,950	$550	$1.1M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	15,830	$50	$712.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	15,380	$30	$384.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,010	$170	$332.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	8,420	$30	$244.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,330	$180	$236.2K

Showing 1–10 of 85

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.

Claims Volume vs. Oregon Distribution

Peacehealth — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

85 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	71	150	7,400	$170	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	71	130	2,610	$200	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	60	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	50	60	3,620	$90	$623.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	481	1,380	540	$140	$363.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	40	80	1,130	$90	$327.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	36	1,500	650	$70	$312.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	105	1,590	590	$50	$236.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	342	400	230	$90	$153.8K

Showing 1–10 of 85

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ramakota Reddy	VA	Cardiovascular Disease Physician	$85K	$0
Lloyd Bellah	VA	Psychiatry Physician	$47.1K	$0
Bret Gorham	OR	Emergency Medicine Physician	$43.6K	$0
Kodjovi Kodjo	MT	Psychiatry Physician	$32.5K	$0
Mark Schuchman	TX	Psychiatry Physician	$16.8K	$1.8K
Brian Mccarthy	OR	Psychiatric/Mental Health Nurse Practitioner	$16.1K	$0
Chen-wen Heh	OR	Psychiatry Physician	$10.8K	$0
Janette Coelho Leal	NV	Psychiatry Physician	$4.6K	$3.1K
Julie Tenbrook	MN	Psychiatric/Mental Health Nurse Practitioner	$5.8K	$0
Ryan Hargraves	IA	Psychiatry Physician	$5.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Lane Mental Health Services, Inc	OR	Community/Behavioral Health Agency	$0	$6M
Bridges Community Health Inc.	OR	Mental Health Counselor	$0	$3.5M
South Lane County Fire And Rescue	OR	Land Ambulance	$346.5K	$1.3M
Michele Savage	OR	Durable Medical Equipment & Medical Supplies	$0	$1.1M
Lisa Parker	OR	Nurse Practitioner	$37.1K	$0
Brandy Zerby	OR	Medical Physician Assistant	$30.8K	$0
Linda Thompson	OR	Speech-Language Pathologist	$12.5K	$0
Genevieve Murstig	OR	Registered Dietitian	$2.7K	$0
Angela Gates	OR	Family Nurse Practitioner	$1.5K	$0

Peacehealth — Billing Profile & Reimbursement Data

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Peacehealth — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References